The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Environmental Health and Engineering, Johns Hopkins Education and Research Center for Occupational Safety and Health, Baltimore, MD, USA.
Nat Rev Urol. 2021 Mar;18(3):160-169. doi: 10.1038/s41585-020-00414-4. Epub 2021 Jan 11.
Poor ergonomics in the operating room can have detrimental effects on a surgeon's physical, psychological and economic well-being. This problem is of particular importance to urologists who are trained in nearly all operative approaches (open, laparoscopic, robotic-assisted, microscopic and endoscopic surgery), each with their own ergonomic considerations. The vast majority of urologists have experienced work-related musculoskeletal pain or injury at some point in their career, which can result in leaves of absence, medical and/or surgical treatment, burnout, changes of specialty and even early retirement. Surgical ergonomics in urology has been understudied and underemphasized. In this Review, we characterize the burden of musculoskeletal injury in urologists and focus on various ergonomic considerations relevant to the urology surgeon. Although the strength of evidence remains limited in this space, we highlight several practical recommendations stratified by operative approach that can be incorporated into practice without interrupting workflow whilst minimizing injury to the surgeon. These recommendations might also serve as the foundation for ergonomics training curricula in residency and continuing medical education programmes. With improved awareness of ergonomic principles and the sequelae of injury related to urological surgery, urologists can be more mindful of their operating room environment and identify ways of reducing their own symptoms and risk of injury.
手术室中的人体工程学不佳会对外科医生的身体、心理和经济福利产生不利影响。这个问题对泌尿科医生尤为重要，因为他们接受过几乎所有手术方法（开放手术、腹腔镜手术、机器人辅助手术、显微镜手术和内镜手术）的培训，每种方法都有其自身的人体工程学考虑因素。绝大多数泌尿科医生在职业生涯中的某个时刻都经历过与工作相关的肌肉骨骼疼痛或损伤，这可能导致休假、医疗和/或手术治疗、倦怠、专业变更甚至提前退休。泌尿科的手术人体工程学研究不足且重视不够。在这篇综述中，我们描述了泌尿科医生肌肉骨骼损伤的负担，并重点介绍了与泌尿科医生相关的各种人体工程学考虑因素。尽管在这个领域证据仍然有限，但我们根据手术方法强调了几个实用的建议，这些建议可以在不中断工作流程的情况下纳入实践，同时最大限度地减少对医生的伤害。这些建议也可以作为住院医师和继续医学教育项目中人体工程学培训课程的基础。随着对人体工程学原则和与泌尿外科手术相关损伤后果的认识提高，泌尿科医生可以更加关注手术室环境，并找到减轻自身症状和受伤风险的方法。
